INTERVENTIONS FOR OPIOID INDUCED RESPIRATORY DEPRESSION
  • Most likely to occur in sedated pts
  • If respirations are depressed:
    • Assess sedation level
    • Reduce infusion rate by 25% when possible
    • Stimulate pt (shake shoulder gently, call by name, ask to breathe)
    • Give oxygen
    • Encourage pt. to deep breathe
  • If pt cannot be aroused or is apneic
    • Administer naloxone (Narcan)
      • for children weighing <40 kg (88 lbs), dilute 0.1 mg naloxone in 10 ml sterile saline to make 10mcg/ml solution and give 0.5mcg/kg
      • for children weighing >40 kg (88 lbs), dilute 0.4 mg ampule in 10 ml sterile saline and give 0.5 ml
    • Administer bolus by slw IV push q2min until effect is obtained
    • Closely monitor pt. Naloxone's duration of antagonist action may be shorter than that of opioid, requiring repeated doses of naloxone
    • Oxygen bag and mask
    • Lower infusion rate